Jason Iannuccilli, MD

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

MD12595 Issued in RI

Practice address

125 Metro Center Blvd Ste 2000
Warwick, RI 02886-1785

Phone

(401) 432-2520

NPI assigned

Apr 23, 2007

Last updated

Mar 18, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 6

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in RI, FL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Diagnostic Radiology

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Florida Hospital Physician Group IncGroup PAC ID 2365679057, 953 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventhealth Port Charlotte Hospital, Port Charlotte, FL, CCN 100077
• Adventhealth Tampa Hospital, Tampa, FL, CCN 100173
• Adventhealth North Pinellas Hospital, Tarpon Springs, FL, CCN 100055
• Adventhealth Sebring Hospital, Sebring, FL, CCN 100109
• Adventhealth Dade City Hospital, Dade City, FL, CCN 100211

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: jiannuccilli648828@adventhealth.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Florida Hospital Physician Group Inc

  dba AdventHealth Medical Group

  • Family Medicine Physician
  • Tampa, FL
  • NPI 1174955256

  RI

  Medicare reassignment Care Compare group NPD
• Rhode Island Medical Imaging Inc

  • Diagnostic Radiology Physician
  • Warwick, RI
  • NPI 1205874930
  NPD (past)
• Adventhealth West Florida Imaging Inc

  dba AdventHealth Imaging Center Central Pasco

  • Radiology Clinic/Center
  • Land O' Lakes, FL
  • NPI 1376247577
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Adventhealth Port Charlotte Inc

  dba Adventhealth Port Charlotte

  • General Acute Care Hospital
  • Port Charlotte, FL
  • NPI 1760299093
  Care Compare affiliation
• Adventist Health System-Sunbelt Inc

  dba AdventHealth Cancer Institute Sebring

  • General Acute Care Hospital
  • Sebring, FL
  • NPI 1083692594
  Care Compare affiliation
• Florida Hospital Dade City Inc

  dba AdventHealth Dade City

  • General Acute Care Hospital
  • Dade City, FL
  • NPI 1215444054
  Care Compare affiliation
• Tarpon Springs Hospital Foundation Inc

  dba AdventHealth North Pinellas

  • General Acute Care Hospital
  • Tarpon Springs, FL
  • NPI 1568473015
  Care Compare affiliation
• University Community Hospital, Inc

  dba AdventHealth Tampa

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1053321919
  Care Compare affiliation
• University Community Hospital, Inc

  dba AdventHealth Tampa Outreach Laboratory

  • Clinical Medical Laboratory
  • Tampa, FL
  • NPI 1134766694

  Hospital

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552867200000",
    "number": "1659599868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 METRO CENTER BLVD STE 2000",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028861785",
            "telephone_number": "401-432-2520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 METRO CENTER BLVD STE 2000",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028861785",
            "telephone_number": "401-432-2520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IANNUCCILLI",
        "first_name": "JASON",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-23",
        "last_updated": "2019-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "RI",
            "license": "MD12595",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A111724",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "RI",
            "license": "LP00021",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "RI",
            "license": "12595",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "RI",
            "license": "12595",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "RI",
            "license": "MD12595",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "J185324",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0A1117240",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nikayla M Iacobbo, PHARM.D.
• Thomas J Iacono, AUD
• Vincent R. Iacono, M.D.
• Justine Faye Iadeluca, APRN, FNP-C
• Alicia Lynn Iafrate
• Farhat Ibrahim, M.D.
• Miranda Icart, PSY.D.
• Ambreen Ijaz, M.D.
• Danielle Imbornone Gallagher, LMHC
• In-Sight

• Vascular & Interventional Radiology Physician in Warwick, RI
• Providers in Warwick, RI by specialty
• Vascular & Interventional Radiology Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.